Rats that engaged in train and acquired fatty acid supplements showed improved responses to bacterial infection and inflammation associated with apical periodontitis, a condition that can develop when dental caries extend to the root canal and trigger infection.
A recent study published in Scientific Reports found that regular physical activity combined with omega-3 supplementation can greatly enhance immune function and lessen the severity of chronic apical periodontitis.
This condition involves inflammation at the apex of the tooth (the tip of the root) and surrounding tissues, most often triggered by untreated cavities. When decay is not properly managed, bacteria can penetrate the root canal and reach the apex, resulting in infection and bone loss around the tooth.
According to the researchers, this is the first evidence that pairing moderate exercise with omega-3 intake can meaningfully reduce the inflammation associated with apical periodontitis. The combined approach helped slow bacterial spread, minimize bone degradation, balance the release of inflammatory molecules, and boost fibroblast activity, cells essential for building and maintaining tissue.
If left unchecked, the infection can ultimately cause tooth loss. The study also highlights a bidirectional link between apical periodontitis and several systemic conditions. Diseases such as diabetes, metabolic syndrome, arteriosclerosis, and kidney disease can worsen the oral infection, while inflammation at the tooth’s apex can, in turn, aggravate these disorders.
“It’s a condition that patients may not even know they have because of its chronic nature, but which can evolve and lead to bone destruction and tooth mobility. In addition, in specific situations, such as a drop in immunity, it can become acute, so the patient starts to feel pain, pus forms at the site, the face can become swollen,” explains Rogério de Castilho, a professor at the Araçatuba School of Dentistry at São Paulo State University (FOA-UNESP) in Brazil. Castilho supervised the study and is supported by FAPESP.
“In rats, physical exercise alone brought about a systemic improvement, regulating the local immune response. In addition, when combined with supplementation, it further reduced the destructive condition caused by endodontic pathology,” explains Ana Paula Fernandes Ribeiro, the first author of the study, carried out during her doctorate at FOA-UNESP.
Less inflammation
The researchers induced apical periodontitis in 30 rats and divided them into three groups. The first group received no intervention. The second and third groups underwent a 30-day swimming regimen.
The third group also received dietary supplementation of omega-3, a polyunsaturated fatty acid known for its therapeutic effects on chronic inflammatory diseases.
The group that only swam had better outcomes than the untreated control group. However, omega-3 supplementation combined with physical exercise regulated the immune response and infection control even better.
Immunohistochemical analyses, which assess how the immune system responds to infection, revealed varying levels of the cytokines interleukin 17 (IL-17) and tumor necrosis factor alpha (TNF-α), indicating the intensity of the inflammatory response.
While the rats that received no treatment had moderate levels of these cytokines, those that exercised had lower levels, and those that took supplementation had the lowest levels.
In addition to having lower levels of these cytokines, the group that exercised had fewer osteoclasts. These are cells that resorb bone tissue, indicating bone loss. The results were even better for the group that consumed omega-3, showing statistically significant differences compared to the animals that received no treatment.
Micro CT scans of the jaws showed that the animals that swam experienced less loss of volume of alveolar bone, which covers the teeth, than those in the control group. The loss was even less in the supplemented group.
For the authors, the study provides new evidence of the benefits of physical activity and omega-3 for the immune system, now with even more obvious repercussions for oral health.
“To know if the same would be true for humans, we’d need a clinical study with a significant number of patients. However, in addition to the many proven benefits of physical exercise and omega-3 consumption, this is yet another important piece of evidence,” Jacinto says.
Reference: “Physical exercise alone or combined with omega-3 modulates apical periodontitis induced in rats” by Ana Paula Fernandes Ribeiro, Michely de Lima Rodrigues, Caroline Loureiro, Nathalia Evelyn da Silva Machado, Cristiane Cantiga-Silva, Pedro Henrique Chaves de Oliveira, Lucino Tavares Angelo Cintra and Rogério Castilho Jacinto, 13 March 2025, Scientific Reports.
DOI: 10.1038/s41598-025-90029-9
The work was supported by FAPESP through Scientific Initiation grants awarded to Michely de Lima Rodrigues (20/13089-3 and 22/04884-0), another co-author of the study.
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